Basic mechanisms of ventricular arrhythmia: Focal activity and reentry

Thomas K. Kurian, Wenwen Li, Igor R. Efimov

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

Much advancement has been made over the past century in elucidating the basic mechanisms of ventricular tachy-arrhythmias that led to improvements in both diagnosing and successfully treating patients at high risk for sudden death. From the initial description of ventricular tachy-arrhythmia by Carl Ludwig in the 1840's to the pioneering work of Carl Wiggers in the 1930's in dog models to the current use of electrode or optical mapping, computer modeling and tools of molecular biology, our understanding of ventricular tachy-arrhythmias have continued to evolve allowing for advancements in treatment with respect to drugs, defibrillators and ablative techniques. Currently the origins of ventricular arrhythmias are rooted in the principles of re-entry and focal or triggered activity. Reentry has traditionally has been divided into 1) anatomical (distinct relationship between pathway and underlying tissue structure) and 2) functional (no relation to clear anatomic boundaries) and require a single wave of excitation traveling in a single direction returning to the initial focus initiated by uni-directional block. Basic elements of re-entry thus far described include non-uniform anisotropy, abnormal cell coupling and tissue geometry. Focal or Triggered Activity is an abnormality in impulse formation that result in 1) oscillations in membrane voltages that occur during the resting potential (delayed after-depolarization - DAD) and 2) oscillations that occur during the action potential plateau or repolarization period (early after-depolarization - EAD). Although the etiology of these rhythm disturbances is complex and multi-factorial, advances thus far at the level of basic science have provided insight into the mechanisms of these processes allowing for continued improvement with respect to diagnosis and treatment of these lethal arrhythmias.

Original languageEnglish (US)
Title of host publicationVentricular Arrhythmia
Subtitle of host publicationFrom Principles to Patients
PublisherNova Science Publishers, Inc.
Pages17-36
Number of pages20
ISBN (Print)9781620815403
StatePublished - Feb 1 2013

Fingerprint

Cardiac Arrhythmias
Defibrillators
Anisotropy
Sudden Death
Membrane Potentials
Action Potentials
Molecular Biology
Electrodes
Dogs
Membranes
Pharmaceutical Preparations
Therapeutics

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Kurian, T. K., Li, W., & Efimov, I. R. (2013). Basic mechanisms of ventricular arrhythmia: Focal activity and reentry. In Ventricular Arrhythmia: From Principles to Patients (pp. 17-36). Nova Science Publishers, Inc..

Basic mechanisms of ventricular arrhythmia : Focal activity and reentry. / Kurian, Thomas K.; Li, Wenwen; Efimov, Igor R.

Ventricular Arrhythmia: From Principles to Patients. Nova Science Publishers, Inc., 2013. p. 17-36.

Research output: Chapter in Book/Report/Conference proceedingChapter

Kurian, TK, Li, W & Efimov, IR 2013, Basic mechanisms of ventricular arrhythmia: Focal activity and reentry. in Ventricular Arrhythmia: From Principles to Patients. Nova Science Publishers, Inc., pp. 17-36.
Kurian TK, Li W, Efimov IR. Basic mechanisms of ventricular arrhythmia: Focal activity and reentry. In Ventricular Arrhythmia: From Principles to Patients. Nova Science Publishers, Inc. 2013. p. 17-36
Kurian, Thomas K. ; Li, Wenwen ; Efimov, Igor R. / Basic mechanisms of ventricular arrhythmia : Focal activity and reentry. Ventricular Arrhythmia: From Principles to Patients. Nova Science Publishers, Inc., 2013. pp. 17-36
@inbook{f9c6159ab6d84311a6931672d885dbc1,
title = "Basic mechanisms of ventricular arrhythmia: Focal activity and reentry",
abstract = "Much advancement has been made over the past century in elucidating the basic mechanisms of ventricular tachy-arrhythmias that led to improvements in both diagnosing and successfully treating patients at high risk for sudden death. From the initial description of ventricular tachy-arrhythmia by Carl Ludwig in the 1840's to the pioneering work of Carl Wiggers in the 1930's in dog models to the current use of electrode or optical mapping, computer modeling and tools of molecular biology, our understanding of ventricular tachy-arrhythmias have continued to evolve allowing for advancements in treatment with respect to drugs, defibrillators and ablative techniques. Currently the origins of ventricular arrhythmias are rooted in the principles of re-entry and focal or triggered activity. Reentry has traditionally has been divided into 1) anatomical (distinct relationship between pathway and underlying tissue structure) and 2) functional (no relation to clear anatomic boundaries) and require a single wave of excitation traveling in a single direction returning to the initial focus initiated by uni-directional block. Basic elements of re-entry thus far described include non-uniform anisotropy, abnormal cell coupling and tissue geometry. Focal or Triggered Activity is an abnormality in impulse formation that result in 1) oscillations in membrane voltages that occur during the resting potential (delayed after-depolarization - DAD) and 2) oscillations that occur during the action potential plateau or repolarization period (early after-depolarization - EAD). Although the etiology of these rhythm disturbances is complex and multi-factorial, advances thus far at the level of basic science have provided insight into the mechanisms of these processes allowing for continued improvement with respect to diagnosis and treatment of these lethal arrhythmias.",
author = "Kurian, {Thomas K.} and Wenwen Li and Efimov, {Igor R.}",
year = "2013",
month = "2",
day = "1",
language = "English (US)",
isbn = "9781620815403",
pages = "17--36",
booktitle = "Ventricular Arrhythmia",
publisher = "Nova Science Publishers, Inc.",

}

TY - CHAP

T1 - Basic mechanisms of ventricular arrhythmia

T2 - Focal activity and reentry

AU - Kurian, Thomas K.

AU - Li, Wenwen

AU - Efimov, Igor R.

PY - 2013/2/1

Y1 - 2013/2/1

N2 - Much advancement has been made over the past century in elucidating the basic mechanisms of ventricular tachy-arrhythmias that led to improvements in both diagnosing and successfully treating patients at high risk for sudden death. From the initial description of ventricular tachy-arrhythmia by Carl Ludwig in the 1840's to the pioneering work of Carl Wiggers in the 1930's in dog models to the current use of electrode or optical mapping, computer modeling and tools of molecular biology, our understanding of ventricular tachy-arrhythmias have continued to evolve allowing for advancements in treatment with respect to drugs, defibrillators and ablative techniques. Currently the origins of ventricular arrhythmias are rooted in the principles of re-entry and focal or triggered activity. Reentry has traditionally has been divided into 1) anatomical (distinct relationship between pathway and underlying tissue structure) and 2) functional (no relation to clear anatomic boundaries) and require a single wave of excitation traveling in a single direction returning to the initial focus initiated by uni-directional block. Basic elements of re-entry thus far described include non-uniform anisotropy, abnormal cell coupling and tissue geometry. Focal or Triggered Activity is an abnormality in impulse formation that result in 1) oscillations in membrane voltages that occur during the resting potential (delayed after-depolarization - DAD) and 2) oscillations that occur during the action potential plateau or repolarization period (early after-depolarization - EAD). Although the etiology of these rhythm disturbances is complex and multi-factorial, advances thus far at the level of basic science have provided insight into the mechanisms of these processes allowing for continued improvement with respect to diagnosis and treatment of these lethal arrhythmias.

AB - Much advancement has been made over the past century in elucidating the basic mechanisms of ventricular tachy-arrhythmias that led to improvements in both diagnosing and successfully treating patients at high risk for sudden death. From the initial description of ventricular tachy-arrhythmia by Carl Ludwig in the 1840's to the pioneering work of Carl Wiggers in the 1930's in dog models to the current use of electrode or optical mapping, computer modeling and tools of molecular biology, our understanding of ventricular tachy-arrhythmias have continued to evolve allowing for advancements in treatment with respect to drugs, defibrillators and ablative techniques. Currently the origins of ventricular arrhythmias are rooted in the principles of re-entry and focal or triggered activity. Reentry has traditionally has been divided into 1) anatomical (distinct relationship between pathway and underlying tissue structure) and 2) functional (no relation to clear anatomic boundaries) and require a single wave of excitation traveling in a single direction returning to the initial focus initiated by uni-directional block. Basic elements of re-entry thus far described include non-uniform anisotropy, abnormal cell coupling and tissue geometry. Focal or Triggered Activity is an abnormality in impulse formation that result in 1) oscillations in membrane voltages that occur during the resting potential (delayed after-depolarization - DAD) and 2) oscillations that occur during the action potential plateau or repolarization period (early after-depolarization - EAD). Although the etiology of these rhythm disturbances is complex and multi-factorial, advances thus far at the level of basic science have provided insight into the mechanisms of these processes allowing for continued improvement with respect to diagnosis and treatment of these lethal arrhythmias.

UR - http://www.scopus.com/inward/record.url?scp=84895239376&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84895239376&partnerID=8YFLogxK

M3 - Chapter

AN - SCOPUS:84895239376

SN - 9781620815403

SP - 17

EP - 36

BT - Ventricular Arrhythmia

PB - Nova Science Publishers, Inc.

ER -